Colour Doppler Sonography of the Knee Joint: A Useful Tool to Discriminate Arthritis From Osteoarthritis ? - ACR Meeting Abstracts

Abstract Number: 118

Colour Doppler Sonography of the Knee Joint: A Useful Tool to Discriminate Arthritis From Osteoarthritis ?

Wolfgang Hartung¹, Nelly Beitinger², Boris P. Ehrenstein¹, Christian Lüring³, Joachim Grifka⁴, Benno Schreiner⁴, Martina Müller⁵ and Martin Fleck¹, ¹Rheumatology & Clinical Immunology, Asklepios Clinic Bad Abbach, Bad Abbach, Germany, ²Rheumatology & Clinical Immunology, Asklepios Klinikum Bad Abbach, Bad Abbach, Germany, ³Orthopaedic and Trauma Surgery, Universitiy Clinic Aachen, Aachen, Germany, ⁴Orthopedic Surgery, University of Regensburg, Bad Abbach, Germany, ⁵Clinic for Internal Medicine I, University Clinic Regensburg, Regensburg

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Knee, osteoarthritis and ultrasound

Session Information

Title: Imaging of Rheumatic Diseases: Ultrasound, Nuclear Medicine and Fluorescence Imaging

Session Type: Abstract Submissions (ACR)

Colour Doppler sonography of the knee joint: A useful tool to discriminate Arthritis from Osteoarthritis ?

Background/Purpose:

To determine the diagnostic value of Colour Doppler ultrasound (CDUS) in patients with inflammatory arthritis (IA) versus osteoarthritis (OA) of the knee joint.

Methods:

Standardized CDUS examinations have been performed in 111 knee joints of 106 patients (70 female, 36 male) presenting with severe OA (n=72) or confirmed IA (n=39) of one or both knee joints, to determine the degree of synovial inflammation in a semiquantitative fashion. To definitely distinguish inflammatory from non-inflammatory disease, synovial fluid has been obtained from every patient within 24 hours after sonography and analyzed synovial fluids containing up to 1000 white blood cells (wbc)/ul were considered non-inflammatory, whereas 5000 or more wbc/ul have been classified as inflammatory, respectively.

Results:

The CDUS sum score of OA patients was determined at 3.3 (range 0-8). In contrast, IA patients exhibited significantly elevated synovitis scores at 5.3 (range 3-9) (p < 0.001). However, high synovial CDUS activity could be observed in OA patients sporadically. Therefore, there is no definitive CDUS threshold that clearly separates OA from IA patients.

Conclusion:

CDUS is a valuable instrument to assist clinicians in distinguishing OA from IA of the knee, but nevertheless should always interpreted within the clinical context.

Table 1: Mean CDUS scores of the patients with osteoarthritis vs. arthritis of the knee.

Scan	OA patients (n = 73)	IA patients (n = 39)
suprapatellar	0.14 (0-2)	0.64 (0-2)
infrapatellar	0.14 (0-2)	0.44 (0-2)
medial longitudinal	1.2 (0-3)	2.0 (1-3)
lateral longitudinal	2.0 (0-3)	2.3 (1-3)
Total score	3.3 (0-8)	5.3 (3-9)**

OA = Osteoarthritis, IA = inflammatory arthritis of the knee, ** (Chi square test: p value < 0.001).

Disclosure:

W. Hartung,

Abbott Immunology Pharmaceuticals,

5,

Pfizer Inc,

5;

N. Beitinger,
None;

B. P. Ehrenstein,

Abbott Immunology Pharmaceuticals,

5,

Pfizer Inc,

5,

Roche Pharmaceuticals,

5;

C. Lüring,
None;

J. Grifka,
None;

B. Schreiner,
None;

M. Müller,
None;

M. Fleck,

Abbott Immunology Pharmaceuticals,

5,

Roche Pharmaceuticals,

5,

Pfizer Inc,

5.

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